In situ genetic engineering of host T-cells based on acellular scaffold strategy: a big but also small step for solid tumor immunotherapy

IF 16.7 2区 医学 Q1 MEDICINE, GENERAL & INTERNAL
Shu-Yan Han, Zi-Xuan Zhao, Jun Wu
{"title":"In situ genetic engineering of host T-cells based on acellular scaffold strategy: a big but also small step for solid tumor immunotherapy","authors":"Shu-Yan Han, Zi-Xuan Zhao, Jun Wu","doi":"10.1186/s40779-024-00517-8","DOIUrl":null,"url":null,"abstract":"<p>The advent of targeted T-cell therapy, with chimeric antigen receptor (CAR) T-cell therapy as the most prominent example, has yielded significant clinical efficacy for both relapsed and refractory hematological malignancies. However, this form of T-cell immunotherapy is often accompanied by severe systemic toxicities, suboptimal response rates, and host immune rejection in clinical settings, which detracts from its therapeutic utility. Additional concerns, such as the time-intensive ex vivo manufacturing process and the substantial treatment costs, also require resolution. Beyond these limitations, the use of CAR T-cell therapy against solid tumors presents an ongoing and formidable challenge. The extensive heterogeneity and complex spatial organization of solid tumors, along with their associated microenvironments, have impeded the broader clinical adoption of T-cell-based tumor immunotherapies [1, 2].</p><p>In the work of Dandia et al. [3], a novel strategy was reported that utilizes an acellular three-dimensional scaffold-based localized approach to program host T cells in situ, thus addressing several major challenges faced by traditional T-cell therapies and offering new hope for the elimination of solid tumors. The polyethylene glycol (PEG) scaffolds, conjugated with poly-L-lysine (PLL) and loaded with ovalbumin (OVA)-specific T-cell receptors (TCRs) lentiviruses (LVs), were implanted in B16-OVA melanoma-bearing mice and demonstrated significant anti-solid tumor efficacy. These bioactive scaffolds effectively recruited host T cells to the tumor site, transduced them with OVA-specific TCRs, and enabled them to home to tumors and draining lymph nodes. This facilitated in vivo T-cell genetic engineering and solid tumor immunotherapy. On one hand, this approach circumvented the need for in vitro manipulation and large-scale expansion of allogeneic T cells by directly utilizing host cells, thereby reducing the common risks associated with traditional adoptive cell therapies. On the other hand, unlike systemic delivery, the scaffold-based in situ localized administration minimized the incidence of “on-target, off-tumor” effects and enhanced the efficiency of regional immunomodulation, making it particularly effective at overcoming immunosuppression within solid tumors.</p><p>As is widely recognized, the ultimate goal of preclinical research is to facilitate successful clinical translation into practical medicine. The unquestionable benefits of this novel in situ immunomodulation strategy include its streamlined one-step, one-day process, as well as its high-efficiency targeting and programming of solid tumors, which engender considerable optimism for the immunotherapy of solid tumors with its ease of operation, reduced cost, and exceptional efficacy. However, the promising results of the current proof-of-concept study represent merely the beginning, and numerous considerations must be addressed before this approach can be applied clinically.</p><p>First of all, biosafety remains the cornerstone of engineered cell therapy design. In the context of lentiviral delivery, the incorporation of foreign viral envelope antigens and the genomic integration of substantial DNA segments adjacent to active genes may heighten the risk of adverse effects. Moreover, these procedures may elicit unforeseen innate immune reactions that could compromise the stability and targeted specificity of the viral vectors. Consequently, it is imperative that the forthcoming generation of lentiviruses is both safe and efficacious for clinical applications. Furthermore, while the bioactive scaffold strategy represents a viable solution that could economize time, financial resources, and effort after treatment, the challenge of mass-producing a sufficient quantity of potent and active virions prior to product commercialization remains formidable [1, 4].</p><p>Secondly, the role of biomaterials as integral components of in situ therapeutic strategies and pivotal elements in market transition necessitates a deeper exploration of the structure–property relationships and the potential immunomodulatory mechanisms inherent to the scaffolds. The study at hand concludes that negatively charged LVs can be anchored to matrices through PLL modification, allowing host immunocytes to infiltrate the implants without complete immobilization [3]. Indeed, PLL-based electrostatic interactions are not confined to material-material and material-cell interfaces but may extend directly to material-receptor interactions. Nevertheless, a paucity of detailed mechanistic studies exists, which hampers the full understanding of the influence of polymeric scaffolds on diverse immune cells. In addition, the field has recently seen the emergence of novel self-therapeutic biomaterials for tumor treatment; these include synthetic amphiphilic cationic polymers that emulate oncolytic peptides (termed oncolytic polymers) [2] and hydroxy acid homopolymers derived from Chinese herbs. Owing to their advantageous chemical processability, cost-effectiveness, abundant availability, and scalability, these functionalized biomaterials stand out as promising contenders for a new therapeutic paradigm. Their synergistic anti-tumor properties have the potential to refine the clinical application of pure cell therapies and to complement existing cancer immunotherapy approaches.</p><p>Lastly, the challenges posed by tumor antigen escape and heterogeneity, particularly in solid tumors, render the elucidation of genetic and epigenetic diversity and the underlying operational mechanisms essential for the tailored treatment of individual tumors and the standardized production of therapeutic agents. Undoubtedly, there is an urgent need for increased interdisciplinary collaboration and the integration of novel techniques [5, 6]. For instance, the molecular signaling pathways and potential mechanisms governing immune cell activities can be elucidated with high-resolution, spatiotemporally controlled single-cell imaging techniques; personalized immunotherapy can benefit from neoantigen discovery and screening, facilitated by high-throughput sequencing, machine learning, and computational prediction. Additionally, the integration of multiple spatial omics, artificial intelligence, and clinical oncology is instrumental in constructing interactive networks within the tumor microenvironment and enhancing clinical management of patients. As technological advancements continue at a swift pace, they hold promise for significantly improving clinical outcomes for patients afflicted with solid tumors.</p><p>In summary, the novel all-in-one PEG-PLL platform presented in this study [3] offers an innovative strategy for the transduction of host T cells in situ, yielding notable anti-tumor effects against solid tumors. While this breakthrough paves the way for a new paradigm in immune cell therapies, it is acknowledged that more efforts must be devoted in the forthcoming years to revolutionizing the treatment of solid tumors.</p><p>Not applicable.</p><dl><dt style=\"min-width:50px;\"><dfn>CAR:</dfn></dt><dd>\n<p>Chimeric antigen receptor</p>\n</dd><dt style=\"min-width:50px;\"><dfn>LVs:</dfn></dt><dd>\n<p>Lentiviruses</p>\n</dd><dt style=\"min-width:50px;\"><dfn>OVA:</dfn></dt><dd>\n<p>Ovalbumin</p>\n</dd><dt style=\"min-width:50px;\"><dfn>PEG:</dfn></dt><dd>\n<p>Polyethylene glycol</p>\n</dd><dt style=\"min-width:50px;\"><dfn>PLL:</dfn></dt><dd>\n<p>Poly-L-lysine</p>\n</dd><dt style=\"min-width:50px;\"><dfn>TCRs:</dfn></dt><dd>\n<p>T cell receptors</p>\n</dd></dl><ol data-track-component=\"outbound reference\"><li data-counter=\"1.\"><p>Zhu C, Wu Q, Sheng T, Shi J, Shen X, Yu J, et al. Rationally designed approaches to augment CAR-T therapy for solid tumor treatment. Bioact Mater. 2024;33:377–95.</p><p>CAS PubMed Google Scholar </p></li><li data-counter=\"2.\"><p>Liu H, Shen W, Liu W, Yang Z, Yin D, Xiao C. From oncolytic peptides to oncolytic polymers: a new paradigm for oncotherapy. Bioact Mater. 2024;31:206–30.</p><p>CAS PubMed Google Scholar </p></li><li data-counter=\"3.\"><p>Dandia HY, Pillai MM, Sharma D, Suvarna M, Dalal N, Madhok A, et al. Acellular scaffold-based approach for in situ genetic engineering of host T-cells in solid tumor immunotherapy. Mil Med Res. 2024;11(1):3.</p><p>CAS PubMed PubMed Central Google Scholar </p></li><li data-counter=\"4.\"><p>Dagher OK, Posey AD Jr. Forks in the road for CAR T and CAR NK cell cancer therapies. Nat Immunol. 2023;24(12):1994–2007.</p><p>Article CAS PubMed Google Scholar </p></li><li data-counter=\"5.\"><p>Walsh LA, Quail DF. Decoding the tumor microenvironment with spatial technologies. Nat Immunol. 2023;24(12):1982–93.</p><p>Article CAS PubMed Google Scholar </p></li><li data-counter=\"6.\"><p>Liu L, Yoon CW, Yuan Z, Guo T, Qu Y, He P, et al. Cellular and molecular imaging of CAR-T cell-based immunotherapy. Adv Drug Deliv Rev. 2023;203: 115135.</p><p>Article CAS PubMed Google Scholar </p></li></ol><p>Download references<svg aria-hidden=\"true\" focusable=\"false\" height=\"16\" role=\"img\" width=\"16\"><use xlink:href=\"#icon-eds-i-download-medium\" xmlns:xlink=\"http://www.w3.org/1999/xlink\"></use></svg></p><p>Not applicable.</p><p>This work was supported by the National Natural Science Foundation of China (52173150), the Guangzhou Science and Technology Program City-University Joint Funding Project (2023A03J0001), and the Postdoctoral Fellowship Program of CPSF (GZC20233297).</p><h3>Authors and Affiliations</h3><ol><li><p>Bioscience and Biomedical Engineering Thrust, the Hong Kong University of Science and Technology (Guangzhou), Nansha, Guangzhou, 511400, Guangdong, China</p><p>Shu-Yan Han, Zi-Xuan Zhao &amp; Jun Wu</p></li><li><p>Department of Nephrology, Center of Kidney and Urology, the Seventh Affiliated Hospital of Sun Yat-Sen University, Shenzhen, 518107, China</p><p>Shu-Yan Han</p></li><li><p>Division of Life Science, the Hong Kong University of Science and Technology, Hong Kong, 999077, China</p><p>Jun Wu</p></li></ol><span>Authors</span><ol><li><span>Shu-Yan Han</span>View author publications<p>You can also search for this author in <span>PubMed<span> </span>Google Scholar</span></p></li><li><span>Zi-Xuan Zhao</span>View author publications<p>You can also search for this author in <span>PubMed<span> </span>Google Scholar</span></p></li><li><span>Jun Wu</span>View author publications<p>You can also search for this author in <span>PubMed<span> </span>Google Scholar</span></p></li></ol><h3>Contributions</h3><p>SYH and JW conceived the commentary. SYH and ZXZ conducted the literature search and wrote the initial manuscript. JW supervised and revised the main manuscript. All authors read and approved the final version manuscript.</p><h3>Corresponding author</h3><p>Correspondence to Jun Wu.</p><h3>Ethics approval and consent to participate</h3>\n<p>Not applicable.</p>\n<h3>Consent for publication</h3>\n<p>Not applicable.</p>\n<h3>Competing interests</h3>\n<p>The authors declare that they have no competing interests.</p><p><b>Open Access</b> This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.</p>\n<p>Reprints and permissions</p><img alt=\"Check for updates. 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0-.92-.08-1.33-.25-.41-.16-.77-.4-1.08-.7-.3-.31-.54-.69-.72-1.13-.17-.44-.26-.95-.26-1.52zm4.61-.62c0-.55-.11-.98-.34-1.28-.23-.31-.58-.47-1.06-.47-.41 0-.77.15-1.08.45-.31.29-.5.73-.57 1.3zm3.01 2.23c.31.24.61.43.92.57.3.13.63.2.98.2.38 0 .65-.08.83-.23s.27-.35.27-.6c0-.14-.05-.26-.13-.37-.08-.1-.2-.2-.34-.28-.14-.09-.29-.16-.47-.23l-.53-.22c-.23-.09-.46-.18-.69-.3-.23-.11-.44-.24-.62-.4s-.33-.35-.45-.55c-.12-.21-.18-.46-.18-.75 0-.61.23-1.1.68-1.49.44-.38 1.06-.57 1.83-.57.48 0 .91.08 1.29.25s.71.36.99.57l-.74.98c-.24-.17-.49-.32-.73-.42-.25-.11-.51-.16-.78-.16-.35 0-.6.07-.76.21-.17.15-.25.33-.25.54 0 .14.04.26.12.36s.18.18.31.26c.14.07.29.14.46.21l.54.19c.23.09.47.18.7.29s.44.24.64.4c.19.16.34.35.46.58.11.23.17.5.17.82 0 .3-.06.58-.17.83-.12.26-.29.48-.51.68-.23.19-.51.34-.84.45-.34.11-.72.17-1.15.17-.48 0-.95-.09-1.41-.27-.46-.19-.86-.41-1.2-.68z" fill="#535353"/></g></svg>\" width=\"57\"/><h3>Cite this article</h3><p>Han, SY., Zhao, ZX. &amp; Wu, J. In situ genetic engineering of host T-cells based on acellular scaffold strategy: a big but also small step for solid tumor immunotherapy. <i>Military Med Res</i> <b>11</b>, 12 (2024). https://doi.org/10.1186/s40779-024-00517-8</p><p>Download citation<svg aria-hidden=\"true\" focusable=\"false\" height=\"16\" role=\"img\" width=\"16\"><use xlink:href=\"#icon-eds-i-download-medium\" xmlns:xlink=\"http://www.w3.org/1999/xlink\"></use></svg></p><ul data-test=\"publication-history\"><li><p>Received<span>: </span><span><time datetime=\"2024-01-08\">08 January 2024</time></span></p></li><li><p>Accepted<span>: </span><span><time datetime=\"2024-01-22\">22 January 2024</time></span></p></li><li><p>Published<span>: </span><span><time datetime=\"2024-02-03\">03 February 2024</time></span></p></li><li><p>DOI</abbr><span>: </span><span>https://doi.org/10.1186/s40779-024-00517-8</span></p></li></ul><h3>Share this article</h3><p>Anyone you share the following link with will be able to read this content:</p><button data-track=\"click\" data-track-action=\"get shareable link\" data-track-external=\"\" data-track-label=\"button\" type=\"button\">Get shareable link</button><p>Sorry, a shareable link is not currently available for this article.</p><p data-track=\"click\" data-track-action=\"select share url\" data-track-label=\"button\"></p><button data-track=\"click\" data-track-action=\"copy share url\" data-track-external=\"\" data-track-label=\"button\" type=\"button\">Copy to clipboard</button><p> Provided by the Springer Nature SharedIt content-sharing initiative </p><h3>Keywords</h3><ul><li><span>Acellular biomaterial scaffold</span></li><li><span>T-cell therapy</span></li><li><span>Solid tumor immunotherapy</span></li><li><span>Biomaterial-biosystem interaction</span></li><li><span>Multidisciplinary and interdisciplinary</span></li><li><span>Clinical transformation</span></li></ul>","PeriodicalId":18581,"journal":{"name":"Military Medical Research","volume":"300 2 1","pages":""},"PeriodicalIF":16.7000,"publicationDate":"2024-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Military Medical Research","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1186/s40779-024-00517-8","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
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Abstract

The advent of targeted T-cell therapy, with chimeric antigen receptor (CAR) T-cell therapy as the most prominent example, has yielded significant clinical efficacy for both relapsed and refractory hematological malignancies. However, this form of T-cell immunotherapy is often accompanied by severe systemic toxicities, suboptimal response rates, and host immune rejection in clinical settings, which detracts from its therapeutic utility. Additional concerns, such as the time-intensive ex vivo manufacturing process and the substantial treatment costs, also require resolution. Beyond these limitations, the use of CAR T-cell therapy against solid tumors presents an ongoing and formidable challenge. The extensive heterogeneity and complex spatial organization of solid tumors, along with their associated microenvironments, have impeded the broader clinical adoption of T-cell-based tumor immunotherapies [1, 2].

In the work of Dandia et al. [3], a novel strategy was reported that utilizes an acellular three-dimensional scaffold-based localized approach to program host T cells in situ, thus addressing several major challenges faced by traditional T-cell therapies and offering new hope for the elimination of solid tumors. The polyethylene glycol (PEG) scaffolds, conjugated with poly-L-lysine (PLL) and loaded with ovalbumin (OVA)-specific T-cell receptors (TCRs) lentiviruses (LVs), were implanted in B16-OVA melanoma-bearing mice and demonstrated significant anti-solid tumor efficacy. These bioactive scaffolds effectively recruited host T cells to the tumor site, transduced them with OVA-specific TCRs, and enabled them to home to tumors and draining lymph nodes. This facilitated in vivo T-cell genetic engineering and solid tumor immunotherapy. On one hand, this approach circumvented the need for in vitro manipulation and large-scale expansion of allogeneic T cells by directly utilizing host cells, thereby reducing the common risks associated with traditional adoptive cell therapies. On the other hand, unlike systemic delivery, the scaffold-based in situ localized administration minimized the incidence of “on-target, off-tumor” effects and enhanced the efficiency of regional immunomodulation, making it particularly effective at overcoming immunosuppression within solid tumors.

As is widely recognized, the ultimate goal of preclinical research is to facilitate successful clinical translation into practical medicine. The unquestionable benefits of this novel in situ immunomodulation strategy include its streamlined one-step, one-day process, as well as its high-efficiency targeting and programming of solid tumors, which engender considerable optimism for the immunotherapy of solid tumors with its ease of operation, reduced cost, and exceptional efficacy. However, the promising results of the current proof-of-concept study represent merely the beginning, and numerous considerations must be addressed before this approach can be applied clinically.

First of all, biosafety remains the cornerstone of engineered cell therapy design. In the context of lentiviral delivery, the incorporation of foreign viral envelope antigens and the genomic integration of substantial DNA segments adjacent to active genes may heighten the risk of adverse effects. Moreover, these procedures may elicit unforeseen innate immune reactions that could compromise the stability and targeted specificity of the viral vectors. Consequently, it is imperative that the forthcoming generation of lentiviruses is both safe and efficacious for clinical applications. Furthermore, while the bioactive scaffold strategy represents a viable solution that could economize time, financial resources, and effort after treatment, the challenge of mass-producing a sufficient quantity of potent and active virions prior to product commercialization remains formidable [1, 4].

Secondly, the role of biomaterials as integral components of in situ therapeutic strategies and pivotal elements in market transition necessitates a deeper exploration of the structure–property relationships and the potential immunomodulatory mechanisms inherent to the scaffolds. The study at hand concludes that negatively charged LVs can be anchored to matrices through PLL modification, allowing host immunocytes to infiltrate the implants without complete immobilization [3]. Indeed, PLL-based electrostatic interactions are not confined to material-material and material-cell interfaces but may extend directly to material-receptor interactions. Nevertheless, a paucity of detailed mechanistic studies exists, which hampers the full understanding of the influence of polymeric scaffolds on diverse immune cells. In addition, the field has recently seen the emergence of novel self-therapeutic biomaterials for tumor treatment; these include synthetic amphiphilic cationic polymers that emulate oncolytic peptides (termed oncolytic polymers) [2] and hydroxy acid homopolymers derived from Chinese herbs. Owing to their advantageous chemical processability, cost-effectiveness, abundant availability, and scalability, these functionalized biomaterials stand out as promising contenders for a new therapeutic paradigm. Their synergistic anti-tumor properties have the potential to refine the clinical application of pure cell therapies and to complement existing cancer immunotherapy approaches.

Lastly, the challenges posed by tumor antigen escape and heterogeneity, particularly in solid tumors, render the elucidation of genetic and epigenetic diversity and the underlying operational mechanisms essential for the tailored treatment of individual tumors and the standardized production of therapeutic agents. Undoubtedly, there is an urgent need for increased interdisciplinary collaboration and the integration of novel techniques [5, 6]. For instance, the molecular signaling pathways and potential mechanisms governing immune cell activities can be elucidated with high-resolution, spatiotemporally controlled single-cell imaging techniques; personalized immunotherapy can benefit from neoantigen discovery and screening, facilitated by high-throughput sequencing, machine learning, and computational prediction. Additionally, the integration of multiple spatial omics, artificial intelligence, and clinical oncology is instrumental in constructing interactive networks within the tumor microenvironment and enhancing clinical management of patients. As technological advancements continue at a swift pace, they hold promise for significantly improving clinical outcomes for patients afflicted with solid tumors.

In summary, the novel all-in-one PEG-PLL platform presented in this study [3] offers an innovative strategy for the transduction of host T cells in situ, yielding notable anti-tumor effects against solid tumors. While this breakthrough paves the way for a new paradigm in immune cell therapies, it is acknowledged that more efforts must be devoted in the forthcoming years to revolutionizing the treatment of solid tumors.

Not applicable.

CAR:

Chimeric antigen receptor

LVs:

Lentiviruses

OVA:

Ovalbumin

PEG:

Polyethylene glycol

PLL:

Poly-L-lysine

TCRs:

T cell receptors

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This work was supported by the National Natural Science Foundation of China (52173150), the Guangzhou Science and Technology Program City-University Joint Funding Project (2023A03J0001), and the Postdoctoral Fellowship Program of CPSF (GZC20233297).

Authors and Affiliations

  1. Bioscience and Biomedical Engineering Thrust, the Hong Kong University of Science and Technology (Guangzhou), Nansha, Guangzhou, 511400, Guangdong, China

    Shu-Yan Han, Zi-Xuan Zhao & Jun Wu

  2. Department of Nephrology, Center of Kidney and Urology, the Seventh Affiliated Hospital of Sun Yat-Sen University, Shenzhen, 518107, China

    Shu-Yan Han

  3. Division of Life Science, the Hong Kong University of Science and Technology, Hong Kong, 999077, China

    Jun Wu

Authors
  1. Shu-Yan HanView author publications

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  2. Zi-Xuan ZhaoView author publications

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  3. Jun WuView author publications

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Contributions

SYH and JW conceived the commentary. SYH and ZXZ conducted the literature search and wrote the initial manuscript. JW supervised and revised the main manuscript. All authors read and approved the final version manuscript.

Corresponding author

Correspondence to Jun Wu.

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Competing interests

The authors declare that they have no competing interests.

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Han, SY., Zhao, ZX. & Wu, J. In situ genetic engineering of host T-cells based on acellular scaffold strategy: a big but also small step for solid tumor immunotherapy. Military Med Res 11, 12 (2024). https://doi.org/10.1186/s40779-024-00517-8

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Keywords

  • Acellular biomaterial scaffold
  • T-cell therapy
  • Solid tumor immunotherapy
  • Biomaterial-biosystem interaction
  • Multidisciplinary and interdisciplinary
  • Clinical transformation
基于细胞支架策略的宿主 T 细胞原位基因工程:实体瘤免疫疗法的一大步,也是一小步
由于这些功能化生物材料具有化学加工性强、成本效益高、供应充足和可扩展性强等优点,它们有望成为新治疗模式的竞争者。最后,肿瘤抗原逸出和异质性带来的挑战,尤其是在实体瘤中,使得阐明基因和表观遗传学的多样性及其潜在的运行机制,对于个体肿瘤的定制治疗和治疗剂的标准化生产至关重要。毫无疑问,目前迫切需要加强跨学科合作和整合新技术[5, 6]。例如,利用高分辨率、时空控制的单细胞成像技术可以阐明分子信号通路和支配免疫细胞活动的潜在机制;在高通量测序、机器学习和计算预测的推动下,新抗原的发现和筛选可以使个性化免疫疗法受益。此外,多种空间 omics、人工智能和临床肿瘤学的整合有助于构建肿瘤微环境中的互动网络,加强对患者的临床管理。总之,本研究[3]提出的新型一体化 PEG-PLL 平台提供了一种原位转导宿主 T 细胞的创新策略,对实体瘤产生了显著的抗肿瘤效果。虽然这一突破为免疫细胞疗法的新范例铺平了道路,但我们认识到,在未来几年中,必须投入更多的努力来彻底改变实体瘤的治疗方法。CAR:嵌合抗原受体LVs:慢病毒OVA:卵清蛋白PEG:聚乙二醇PLL:聚 L-赖氨酸TCRs:T 细胞受体Zhu C, Wu Q, Sheng T, Shi J, Shen X, Yu J, et al.Bioact Mater.2024;33:377-95.CAS PubMed Google Scholar Liu H, Shen W, Liu W, Yang Z, Yin D, Xiao C. From oncolytic peptides to oncolytic polymers: a new paradigm for oncotherapy.Bioact Mater.2024;31:206-30.CAS PubMed Google Scholar Dandia HY, Pillai MM, Sharma D, Suvarna M, Dalal N, Madhok A, et al. Acellular scaffold-based approach for in situ genetic engineering of host T-cells in solid tumor immunotherapy.Mil Med Res. 2024;11(1):3.CAS PubMed PubMed Central Google Scholar Dagher OK, Posey AD Jr.CAR T 和 CAR NK 细胞癌症疗法的岔路口。Nat Immunol.2023;24(12):1994-2007.Article CAS PubMed Google Scholar Walsh LA, Quail DF.利用空间技术解码肿瘤微环境。Nat Immunol.2023;24(12):1982-93.Article CAS PubMed Google Scholar Liu L, Yoon CW, Yuan Z, Guo T, Qu Y, He P, et al. Cellular and molecular imaging of CAR-T cell-based immunotherapy.Adv Drug Deliv Rev. 2023; 203: 115135.Article CAS PubMed Google Scholar Download referencesNot applicable.本研究得到了国家自然科学基金项目(52173150)、广州市科技计划市校联合资助项目(2023A03J0001)和中国公共卫生基金博士后基金项目(GZC20233297)的资助。作者及工作单位香港科技大学(广州)生物科学与生物医学工程研究中心,中国广东省广州市南沙区,邮编:511400韩淑艳,赵子璇 &amp;Jun WuDepartment of Nephrology, Center of Kidney and Urology, the Seven Affiliated Hospital of Sun Yat-sen University, Shenzhen, 518107, ChinaShu-Yan HanDivision of Life Science, the Hong Kong University of Science and Technology, Hong Kong, 999077、ChinaJun Wu作者:韩淑艳查看作者发表的论文您也可以在PubMed Google Scholar中搜索该作者赵子轩查看作者发表的论文您也可以在PubMed Google Scholar中搜索该作者吴俊查看作者发表的论文您也可以在PubMed Google Scholar中搜索该作者ContributionsSYH和JW构思了评论。SYH和ZXZ进行了文献检索并撰写了初稿。JW 指导并修改了主要稿件。伦理批准和参与同意书不适用.发表同意书不适用.利益冲突作者声明他们没有利益冲突.开放存取本文采用知识共享署名 4.0 许可协议进行许可。
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来源期刊
Military Medical Research
Military Medical Research Medicine-General Medicine
CiteScore
38.40
自引率
2.80%
发文量
485
审稿时长
8 weeks
期刊介绍: Military Medical Research is an open-access, peer-reviewed journal that aims to share the most up-to-date evidence and innovative discoveries in a wide range of fields, including basic and clinical sciences, translational research, precision medicine, emerging interdisciplinary subjects, and advanced technologies. Our primary focus is on modern military medicine; however, we also encourage submissions from other related areas. This includes, but is not limited to, basic medical research with the potential for translation into practice, as well as clinical research that could impact medical care both in times of warfare and during peacetime military operations.
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